Child care, health care

Rural families face transportation, language barriers

October 19, 2007

CLARION — John Holt’s brother recently moved to town to supply some child-rearing help. Holt, who’s raising his two sons in Clarion, had been scrambling to find day care for them while he’s at work.

‘‘Before that I was having to find someone watch the kids,’’ said Holt.

That, according to Kathy Nicholls, was no easy task.

‘‘We were trying to find day care and everybody was full,’’ said Nicholls, assistant administrator for the Wright County Department of Health. ‘‘There were no more slots. There’s a real shortage of quality day care in rural Iowa.’’

Nicholls lauds the work that employees do within the Department of Health, and in connected programs, to reach struggling families in the county.

Holt, too, has words of praise. He said Nicholls and others have supplied tips that have helped him become a better parent. Nicholls added, ‘‘He’s a good dad and wants to take care of his children, and he’s also a good worker.’’

But Nicholls and other officials say that even people’s best efforts have not erased the long stretches of space where key services such as medical care are tough to find. It’s a problem Nicholls says is not unique to Wright County, but one of the thorny traits of life in rural Iowa.

Child care is one shortage residents notice — especially when they’re seeking a good place to lodge their very young children.

‘‘Our center is licensed to take 89 children, and we stay full all the time,’’ said Janet Hennigar director of Kids Korner in Clarion. She said the center also has a waiting list.

At least some home-based day care providers say their centers are also full.

‘‘I stay filled up most of the time, and I think most of my friends who have day care stay pretty full,’’ said Kim Thompson, whose home-based day care is in Eagle Grove.

Kristie Daily, who runs home day care for eight children at a time in Belmond, also said demand seems to be up. Daily has run her day care for seven years, but she said calls, in the last year and a half, have multiplied from about one or two a month to two or three a week.

‘‘It seems like there are more kids,’’ she said.

But some numbers suggest there are not. For instance, enrollment in the Eagle Grove Community School District — as in many rural school districts — has been dropping over the past several years. Certified enrollment has dropped from 906.5 in the fall of 2005 to 852.2 in the fall of 2007. The district counts home-school students who are dual-enrolled as one-tenth of a student.

So, why would the demand for day care be greater now than it was a few years ago?

‘‘I think parents are getting more and more educated on what to look for,’’ said Amy Shannon, the home child care evaluation specialist for Hamilton, Humboldt and Wright counties. ‘‘They are trying to find places that have educational activities ... (and) they may be calling around because they aren’t finding that.”

Shannon, whose work is funded by the organization Building Families-Empowerment, emphasized that greater scrutiny on the part of parents is just one possible factor for the apparent day care scarcity. She added that the day care shortage is especially acute for infants.

Transportation and other barriers

Interpreter Maria Hernandez says she has had to make several health care appointments that her clients couldn’t keep. A Spanish-English interpreter with the Wright County Department of Health, Hernandez works with Hispanic residents who, she explained, face several obstacles that keep them from receiving medical care.

One of those hurdles is simply finding a ride.

‘‘If you know people, you might be able to get a ride from somebody, but if not most of the time people don’t go to their appointments because they can’t get a ride,’’ said Hernandez.

Hernandez said missed meetings have at times numbered as high as eight or nine.

‘‘I don’t know if they believe me anymore, if they’re going to show up,’’ said Hernandez.

Some of the problems stem from language.

‘‘We don’t go with them to their appointments,’’ said Hernandez. ‘‘We let them know they need to take interpreters. They might know friends, they might have a relative. Or they ask, ’Do you know anyone who speaks English who can help me?’’’

About one or two each week go to the Webster City Free Clinic in neighboring Hamilton County, according to Jackie Butler, the clinic director. Butler said the clinic has a volunteer interpreter for Spanish speakers, and a clinic official in Eagle Grove noted a telephone translation service that residents can use, as well.

But if residents are under duress shortages can feel magnified, and long bands of rural roads can become daunting. Words can seem cryptic, too, especially when medical conditions are at stake.